CHA News Article

DHCS Provides Details on Transition to APR-DRG Payment System

Effective July 1, 2013, reimbursement for hospital inpatient services provided to Medi-Cal beneficiaries will be based on a new diagnosis-related group (DRG)-based methodology. The new payment system will use the All-Patient Refined DRGs (APR-DRGs) algorithm.  In order to help hospitals prepare for this transition, the Department of Health Care Services has prepared the attached documents. One provides a summary of the project, including background information, major policy decisions and APR-DRG pricing. The other addresses the treatment authorization request process and changes to technical billing requirements. For details on the transition to the APR-DRG payment system, go to